Silveira Rossi João Leonardo, Barbalho Sandra Maria, Reverete de Araujo Renan, Bechara Marcelo Dib, Sloan Kátia Portero, Sloan Lance Alan
Department of Biochemistry and Pharmacology, School of Medicine, University of Marília, Marília, São Paulo, Brazil.
Postgraduate Program in Structural and Functional Interactions in Rehabilitation - University of Marília, Marília, São Paulo, Brazil.
Diabetes Metab Res Rev. 2022 Mar;38(3):e3502. doi: 10.1002/dmrr.3502. Epub 2021 Oct 15.
Metabolic syndrome (MS) is a chronic non-infective syndrome characterised clinically by a set of vascular risk factors that include insulin resistance, hypertension, abdominal obesity, impaired glucose metabolism, and dyslipidaemia. These risk factors are due to a pro-inflammatory state, oxidative stress, haemodynamic dysfunction, and ischaemia, which overlap in 'dysmetabolic' patients. This review aimed to evaluate the relationship between the traditional components of MS with cardiovascular disease (CVD), inflammation, and oxidative stress. MEDLINE-PubMed, EMBASE, and Cochrane databases were searched. Chronic low-grade inflammatory states and metaflammation are often accompanied by metabolic changes directly related to CVD incidence, such as diabetes mellitus, hypertension, and obesity. Moreover, the metaflammation is characterised by an increase in the serum concentration of pro-inflammatory cytokines, mainly interleukin-1 β (IL-1β), IL-6, and tumour necrosis factor-α (TNF-α), originating from the chronically inflamed adipose tissue and associated with oxidative stress. The increase of reactive oxygen species overloads the antioxidant systems causing post-translational alterations of proteins, lipids, and DNA leading to oxidative stress. Hyperglycaemia contributes to the increase in oxidative stress and the production of advanced glycosylation end products (AGEs) which are related to cellular and molecular dysfunction. Oxidative stress and inflammation are associated with cellular senescence and CVD. CVD should not be seen only as being triggered by classical MS risk factors. Atherosclerosis is a multifactorial pathological process with several triggering and aetiopathogenic mechanisms. Its medium and long-term repercussions, however, invariably constitute a significant cause of morbidity and mortality. Implementing preventive and therapeutic measures against oxy-reductive imbalances and metaflammation states has unquestionable potential for favourable clinical outcomes in cardiovascular medicine.
代谢综合征（MS）是一种慢性非感染性综合征，其临床特征为一系列血管危险因素，包括胰岛素抵抗、高血压、腹型肥胖、糖代谢受损和血脂异常。这些危险因素归因于促炎状态、氧化应激、血流动力学功能障碍和局部缺血，这些因素在“代谢紊乱”患者中相互重叠。本综述旨在评估MS的传统组成部分与心血管疾病（CVD）、炎症和氧化应激之间的关系。检索了MEDLINE-PubMed、EMBASE和Cochrane数据库。慢性低度炎症状态和亚炎症常伴有与CVD发病率直接相关的代谢变化，如糖尿病、高血压和肥胖。此外，亚炎症的特征是促炎细胞因子血清浓度升高，主要是白细胞介素-1β（IL-1β）、IL-6和肿瘤坏死因子-α（TNF-α），这些细胞因子源自慢性炎症的脂肪组织并与氧化应激相关。活性氧的增加使抗氧化系统不堪重负，导致蛋白质、脂质和DNA的翻译后改变，从而引发氧化应激。高血糖导致氧化应激增加和晚期糖基化终产物（AGEs）的产生，而AGEs与细胞和分子功能障碍有关。氧化应激和炎症与细胞衰老及CVD相关。CVD不应仅被视为由经典的MS危险因素触发。动脉粥样硬化是一个多因素的病理过程，有多种触发因素和发病机制。然而，其中长期影响始终是发病和死亡的重要原因。针对氧化还原失衡和亚炎症状态实施预防和治疗措施，在心血管医学中无疑具有产生良好临床结果的潜力。
